Screen Everybody for Pancreatic Cancer? Where Is the Discussion of Evidence, Harms?

Continuing last week's spontaneous theme (we didn't make the claims and write the
stories) of runaway enthusiasm for various screening tests by some
researchers and journalists....

The HealthDay news service reported
on a study, published in the Oct. 28 issue of the journal Nature, that
they say "provides new insight into the genetics of pancreatic cancer."

In the story, they let one of the researchers get away with saying -- almost unchallenged --

"What's
important about this study is that it's objective data in support of
why everyone should be screened for pancreatic cancer."

Mind you, this was a study that looked at tissue from just seven patients.

The story continued with its breathless enthusiasm for the pancreatic cancer screening idea:

"In the future, new imaging techniques and blood tests
will offer hope for early detection, the study noted. And just as
people have a colonoscopy when they turn 50, "perhaps they should have
an endoscopy of their upper gastrointestinal organs that includes an
ultrasound of the pancreas," said (the researcher)."

The very end of the story included some skepticism from Dr. Len Lichtenfeld of the American Cancer Society:

"Lichtenfeld, however, says it's "a bit optimistic" to
suggest that current technologies, such as ultrasound, can diagnose
pancreatic cancer early enough to make a difference. Another cancer
with virtually no symptoms in its earlier stages -- ovarian cancer --
is not often found with ultrasound, he noted."

But nowhere in the story was there a discussion of the harms of
screening. All screening tests cause harm. This researchers' suggestion
was that all 50-year-olds might have endoscopies. Just last week a new study reported
that 1 in 100 people who had colonoscopy or upper-gastrointestinal
endoscopy had complications serious enough to send them to the
emergency room -- a much higher rate than expected.

But in our screening enthusiasm -- screen everybody at all costs --
over and over again we tend to trumpet the potential benefits and
minimize or ignore the potential harms and overall, fail to evaluate
the quality of the evidence.

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.